终末期肝病合并感染诊治的热点与难点

Highlights of diagnosis and treatment for end stage of liver disease with infection

终末期肝病（End stage of liver disease，ESLD）于20世纪80年代提出，但时至今日仍无严格定义。在ESLD发生发展中，感染因素既是因也是果，即感染可以诱发或加重ESLD肝功能失代偿的发生，也是ESLD发展过程中最容易出现的并发症之一。多重耐药菌、多器官损伤、抗菌药物选择、营养支持治疗、肠道微生态紊乱等是临床一线医师面临的难点问题，ESLD合并感染的诊疗规范迫切需要提高。

The term of end stage of liver disease （ESLD） has been used since the 1980s, but there is still no restrict definition. Infections are both cause and effect in development of ESLD, that is infection not only induce or exacerbate ESLD, but also are the most common complication of ESLD. Multi-drug resistant bacteria, multi-organ injury, antimicrobial drug choice, supporting treatment, intestinal microecological disorder are difficult problems in ESLD with infections, so standardization of diagnosis and treatment of this condition needs to be improved urgently.